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Sutton, Amy M. "Executive Function in the Presence of Sleep Disordered Breathing." Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/cps_diss/16.
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The purpose of the study was to investigate whether sleep-disordered breathing (SDB) impairs executive functioning in children. Additionally, the study sought to identify the executive functions at risk in SDB and the contribution of daytime sleepiness. SDB represents a spectrum of upper airway conditions that can be mild, such as snoring, or severe, such as obstructive sleep apnea (OSA). Children with these problems may present with excessive sleepiness, failure to thrive, and a variety of cognitive and behavioral dysfunctions including impaired executive functioning. Beebe and Gozal (2002) developed a theoretical model to explain the impact of sleepiness and hypoxia on executive functioning. This model provided a framework to examine links between the medical disorder and the neuropsychological consequences. Twenty-seven children with suspected SDB were tested with polysomnography (PSG) and a neuropsychological battery. Parents completed subjective measures of cognitive function and sleep symptoms. The children were ages 8 to 18 and had no congenital or acquired brain damage. They were matched for age and gender with 21 healthy controls. The executive function protocol included subtests from the Delis-Kaplan Executive Function System (D-KEFS), the digit span subtest from the Wechsler Intelligence Scale for Children (WISC-IV), the Tower of London-II-Drexel University (TOL-II), the Behavioral Rating Inventory of Executive Functioning (BRIEF), and the Conners’ Continuous Performance Test (CPT-II). Statistical analysis was performed using 2 statistical software packages, SAS and NCSS. Regression analysis was used to evaluate all variables. Due to significant group differences in socio-economic status (SES), SES was included as a covariate, along with IQ. No group differences in IQ were found. Significantly less robust executive function in children with SDB was identified in the domains of cognitive flexibility and impulsivity. Additionally, poorer executive planning and overall inattentiveness was also associated with SDB. Level of significance was set at 0.05 and trends (0.05 < p < 0.10) were acknowledged. Other areas of executive function, including working memory, behavioral and emotional inhibition, and processing speed were not associated with SDB. Moreover, academic functioning was significantly lower in children with SDB, although the differences can be shared equally with SDB, SES and IQ.
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BALIAN, ARAXI. "EFFECTIVENESS OF ORTHODONTIC TREATMENT WITH PREFABRICATED MYOFUNCTIONAL APPLIANCES IN CHILDREN WITH SLEEP-RELATED BREATHING DISORDERS AND OBSTRUCTIVE SLEEP APNEA: AN 18-MONTH FOLLOW-UP." Doctoral thesis, Università degli Studi di Milano, 2022. http://hdl.handle.net/2434/915635.
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Sleep-Related Breathing Disorders (SRBD) include various clinical entities, from primary snoring to Obstructive Sleep Apnea Syndrome (OSAS). They are characterized by intermittent partial or complete (hypopnea/apnea) upper airway obstruction during sleep which lead to sleep disturbance, cardio-respiratory, and neuro-behavioral impairments. Malocclusion and oral-facial dysfunctions such as having a retrusive bite, narrow maxilla, mandibular hypoplasia, oral breathing, or visceral swallowing are considered risk factors for SRBD and OSAS in pre-schoolers.
The present study aims to assess the effectiveness of orthodontic treatment in childhood SRBD and the changes which occur in oral functions and cranio-facial structures.
Participants were recruited if they were less than 6 years of age, presented signs and symptoms of SRBD together with malocclusion and/or oral dysfunctions, and had a baseline apnea index < 5 event/h. Children were assigned to a 12-month treatment with a preformed myofunctional appliance (EFline®, Orthoplus), then to an additional 6-month retention period. At baseline, all children underwent physical examination, orthodontic assessment, nocturnal polygraphy, lateral cephalograms and dental casts. A 6-month nocturnal polygraphy was performed only in OSAS patients. Validated tools for assessing risk of SRBD and OSAS (Sleep Clinical Score, SCS), frequency of sleep disturbances (Sleep Disturbances Scale for Children, SDSC) and neuro-behavioral impairment (Child Behavior Checklist, CBCL) were performed at baseline (T0) and after 12 months (T1). Custom cephalometric analyses and dental arch width measurements were digitally performed at baseline and after 18 months (T2).
Of the 12 patients initially recruited (4 females, 8 males; mean age 5.0±0.47 years), one child dropped-out. Overall, children tolerated the treatment well and recovered from oral dysfunctions (p<0.001). The OSAS subgroup completely recovered from apnea (AHI<1). Significant improvements were seen in respiratory, sleep and dento-skeletal variables: mean SCS (p<0.001), SDSC and CBCL (p<0.01) scores decreased after 12 months; a mean increase of 2-3 mm occurred in pharyngeal airway widths (p<0.01) and 6 mm in mandibular length (p<0.001), a less hyperdivergent facial growth pattern and favourable advancement of the hyoid bone occurred; mean inter-canine widths increased by 2.3-3 mm in the mandible (p<0.001) and in the maxilla (p<0.05). No significant differences were detected between OSAS and SRBD non-OSAS subgroups with the exception of the SCS and CBCL scores at baseline which were resolved after treatment.
Orthodontic treatment with PMAs may produce significant improvements in respiratory and sleep patterns together with significant cranio-facial and dental changes. PMAs might be an effective tool in the multidisciplinary treatment of SRBD and mild-to-moderate OSAS in pre-schooled children.
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Li, Chutu. "The effects of CPAP tube reverse flow." Click here to access this resource online, 2008. http://hdl.handle.net/10292/659.
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CPAP is the most common treatment for moderate to severe sleep apnea in adults. Despite its efficacy, patients’ safety, comfort and compliance are issues to be considered and improved in CPAP design. The issues include condensation, carbon dioxide in inhaled air, humidity and temperature of inhaled air. When a CPAP user breaths deeply, there will be some air not fully expelled and may be driven back into the heated air delivery tube (HADT). An interest has existed in what impacts this so called reverse flow may bring about to the CPAP use. The main objectives of this research are to quantify the reverse flow and its influence on carbon dioxide re-breathing, delivered humidity to the patient and condensation in the HADT. Within this thesis, two computer models of the CPAP system have been constructed on Simulink™ in the Matlab™ environment. One is about the CPAP fluid dynamic performance and carbon dioxide re-breathing and the other is on thermodynamic performance. The models can predict the dynamic behaviour of the CPAP machine. They are able to mimic the breath induced airflow fluctuation, and flow direction changes over wide real working ranges of ambient conditions, settings and coefficients. These models can be used for future analysis, development, improvement and design of the machine. The fluid dynamic and thermodynamic models were experimentally validated and they have proved to be valuable tool in the work. The main conclusions drawn from this study are: • Reverse flow increases when breaths load increases and pressure setting decreases. • Reverse flow does not definitely add exhaled air to the next inhalation unless the reverse flow is relatively too much. • Mask capacity does not influence the reverse flow. • The exhaled air re-breathed is mainly due to that stays in the mask, therefore larger mask capacity increases the exhaled air re-breath and the percentage of exhaled air in next inhalation drops when the breath load increases. • Deep breathing does not significantly change the total evaporation in chamber. • When deep breathing induced reverse flow occurs, condensation occurs or worsens in the HADT near the mask. This happens only when the humidity of the airflow from the CPAP is much lower than that of the exhaled air and the tube wall temperature is low enough for condensation to occur. • The deep breathing and reverse flow do not significantly influence the average inhaled air temperature. • The overall specific humidity in inhaled air is lower under deep breathing. • Mask capacity does not influence the thermal conditions in the HADT and the inhaled air specific humidity. Also the mask capacity does not significantly influences the inhaled air temperature.
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Zhang, Xinyan. "Uncovering the sleep pathway in the social profile of Rett syndrome." Electronic Thesis or Diss., Lyon 1, 2022. http://www.theses.fr/2022LYO10128.
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Le sommeil est essentiel pour maintenir une santé optimale. Le sommeil problématique se retrouve avec une plus grande fréquence et sévérité chez les enfants atteints de troubles neurodéveloppementaux et psychiatriques. De plus, le sommeil problématique est associé à un fonctionnement psychosocial plus faible pendant la journée. Le syndrome de Rett (RTT), en tant que l'un des handicaps multiples génétiques les plus courants et les plus graves chez la femme, est fortement lié au gène mutant de la protéine de liaison méthyl-CpG 2 (MECP2) sur le chromosome X. Les formes phénotypiques variantes de l'RTT présentent un spectre de symptomatologie similaire à celui de l'RTT classique, mais présentent des différences subtiles dans certaines caractéristiques cliniques, variante d’épilepsie précoce (variante de Hanefeld, liée au gène mutant X-linked cyclin-dependent kinase-like 5, CDKL5), variante congénitale (variante de Rolando, liée au gène forkhead box G1, FOXG1) et variante de la parole préservée (variante de Zappella, également liée à MECP2). Le syndrome de Rett concerne 1 naissance sur 10 000 à 15 000, ce qui représente 40 à 50 nouveaux enfants malades chaque année en France. Le RTT se caractérise par un arrêt du développement environ 6 à 18 mois après la naissance, la présence de mouvements stéréotypés de la main et des anomalies de la démarche coïncidant avec la perte des compétences acquises de la main intentionnelle et du langage parlé. L’enfant se retire socialement. D'autres signes également décrits dans les profils cliniques du RTT comprennent les crises d'épilepsie, les difficultés respiratoires, le tonus musculaire anormal, la scoliose, ainsi que les troubles du sommeil. En général, les résultats physiopathologiques du RTT suggèrent des activités corticales anormales et une dysmaturité de la fonction du tronc cérébral, ce qui est essentiel pour maintenir un état adéquat pendant le sommeil ou l'éveil. Cependant, il n'existe pas d'étude scientifique sur la relation entre les anomalies du sommeil et les troubles sociaux dans le RTT. Ainsi, ce travail de doctorat s'est orienté vers ce sujet pour lier le jour et la nuit en RTT. Premièrement, nous avons entrepris au total cinq revues systématique de toutes les études précédentes sur les performances sociales non verbales et le sommeil réalisé sur des personnes atteintes de RTT. Deuxièmement, nous avons analysé les enregistrements polysomnographiques dans un échantillon clinique d'individus atteints de RTT présentant les mutations MECP2. Nous avons étudié leur macrostructure du sommeil et leur respiration pendant le sommeil. En outre, nous avons examiné les traits phénotypiques possibles via une approche analytique stratifiée par caractéristiques cliniques et génétiques. Pour examiner les profils sociaux chez les personnes atteintes de RTT, nous avons extrait 25 items liés au comportement social du questionnaire ‘Rett Syndrome Behavior Questionnaire’, qui étaient corrélés à leur sommeil.De manière générale, nous pouvons conclure que le sommeil dans le phénotype social des individus atteints de RTT est lié à des déficiences sensorimotrices progressives. Par conséquent, à l'avenir, la physiopathologie du système sensorimoteur devrait faire l'objet d'une plus grande attention dans l'étude du sommeil et de la vie sociale des personnes atteintes de RTT. En outre, nous attendons avec impatience de nouvelles recherches sur la démonstration des effets des thérapies sensorimotrices sur les troubles du sommeil et les déficiences socialesSleep is essential for maintaining optimal health. In children with neurodevelopmental and psychiatric disorders, problematic sleep is found with greater frequency and severity. Furthermore, problematic sleep is associated with poorer psychosocial functioning during the daytime. Rett Syndrome (RTT), one of the most common and severe genetic multi-disabilities in females, is strongly linked to the mutant methyl-CpG binding protein 2 gene (MECP2) on the X chromosome. Variant phenotypic forms of RTT present a spectrum of symptomatology similar to that of classical RTT but show subtle differences in some clinical features, including the Early Seizure Variant (ESV, Hanefeld variant, linked to mutant gene X-linked cyclin-dependent kinase-like 5, CDKL5), congenital variant (CV, Rolando variant, linked to the forkhead box G1 gene, FOXG1) and preserved speech variant (PSV, Zappella variant, also linked to MECP2). RTT affects 1 in 10,000 to 15,000 births, which represents 40 to 50 new cases each year in France. RTT is characterized by developmental arrest around 6-18 months after birth, the presence of stereotypical hand movements, and gait abnormalities coinciding with the loss of acquired purposeful hand skills and spoken language. The child withdraws socially. Other signs also described in RTT clinical profiles include epileptic seizure, breathing difficulties, abnormal muscle tone, scoliosis/kyphosis, as well as disturbed sleep. Accumulating pathophysiological findings in RTT suggest abnormal cortical activities and dysmaturity of the brainstem function, which is key in maintaining proper status during sleep or wakefulness. However, there is no scientific study investigating the relationship between sleep abnormalities and social impairments in RTT. Therefore, this doctoral work is subjected to this topic to link the day and night together in RTT. First, we undertook five systematic reviews of all previous studies on non-verbal social performance and sleep in RTT. Then, we analyzed polysomnographic recordings in a clinical sample of RTT individuals with MECP2 mutations. We studied their sleep macrostructure and respiration during sleep. In addition, we examined possible phenotypic traits via a stratified analytical approach to clinical and genetic characteristics. Lastly, to examine social profiles in RTT individuals, we extracted 25 social behavior items from the Rett Syndrome Behavior Questionnaire, and correlated them to their sleep. Overall, we can conclude that sleep in the social phenotype of individuals with RTT is related to progressive sensorimotor impairments. Therefore, in the future, the pathophysiology of the sensorimotor system should receive more attention in the study of sleep and the social life of individuals with RTT. In addition, we look forward to furthering research demonstrating the effects of sensorimotor therapies on sleep and social impairments
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Ng, Kwok-keung Daniel. "Sleep related breathing disorders in children /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36223724.
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Ng, Kwok-keung Daniel, and 吳國強. "Sleep related breathing disorders in children." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45007688.
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Davies, Robert J. O. "Sleep disordered breathing and the cardiovascular system." Thesis, University of Southampton, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.404009.
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Smith, Lindsay Anne. "Sleep-disordered breathing and chronic heart failure." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/29371.
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Methods: Patients with stable symptomatic chronic heart failure were screened for sleep-disordered breathing by home sleep study. Daytime sleepiness was assessed by Epworth Sleepiness Scale and heart failure severity by symptom class, left ventricular ejection fraction and serum N-terminal pro-brain natriuretic peptide concentrations. In a subset of patients, synchronous in-laboratory limited sleep studies and polysomonography, and home limited sleep studies, were performed prospectively. Patients with obstructive sleep apnoea and stable symptomatic chronic heart failure were randomised to nocturnal auto-titrating continuous positive airway pressure or sham for six weeks each in crossover design. Results: In the era of modern therapy, sleep-disordered breathing is common in patients with stable symptomatic chronic heart failure, predominantly obstructive in aetiology, without clear relationship to heart failure severity and is difficult to diagnose because of major overlap in symptomatology. Limited sleep studies compare well diagnostically to polysomnography when tested under identical patient and environmental conditions but less so when tested in the home setting. Auto-titrating continuous positive airway pressure improves daytime sleepiness is patients with obstructive sleep apnoea and chronic heart failure but not other subjective or objective measures of heart failure severity. Conclusions: Sleep-disordered breathing is difficult to detect clinically in patients with chronic heart failure, and as such, the diagnosis is reliant on accurate sleep studies. However, the clinical utility of limited sleep studies in detection and diagnosis of sleep-disordered breathing is restricted by a number of technical and situational factors which are exacerbated in patients with chronic heart failure. The potential therapeutic benefits of continuous positive airway pressure in patients with obstructive sleep apnoea and chronic heart failure are achieved by alleviation of obstructive sleep apnoea rather than by improvement in cardiac function.
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Pirilä-Parkkinen, K. (Kirsi). "Childhood sleep-disordered breathing – dentofacial and pharyngeal characteristics." Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514296024.
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Abstract The aim of this work was to examine distinct dentofacial and pharyngeal features in children with sleep-disordered breathing (SDB). A further aim was to test the validity of the conventional methods used in orthodontics for recognition of obstructed airways. Seventy children (36 girls, 34 boys, age range 4.2–11.9 years), who were diagnosed as having SDB during the years 2000–2002, constituted the source of subjects for four separate studies. The study protocol included otorhinolaryngological and orthodontic examinations. Dental impressions and lateral cephalograms were taken. In addition, upper airway was imaged in 36 children in different head postures by magnetic resonance imaging (MRI). Age- and gender-matched healthy children were used as controls. The results showed that children with SDB had increased overjet, smaller overbite, narrower upper and shorter lower dental arches and higher incidence of anterior open bite and distal molar relationship when compared with control children. The severity of the obstruction correlated with larger deviations from normal in the dental characteristics. There were more children with crowding and with anterior open bite with increased severity of the disorder. Children with SDB displayed an increased sagittal jaw relationship, a more vertical growth pattern of the mandible, a longer and thicker soft palate, a lower hyoid bone position, larger craniocervical angles and narrower pharyngeal airway measured at multiple levels, when compared with the controls. Deviation in pharyngeal variables showed highest correlation with the severity of SDB. MRI indicated a smaller than normal oropharyngeal airway in children with SDB. The effect of head posture on pharyngeal airway dimensions differed in children with SDB when compared with the controls. These findings verify that the developmental course of occlusal characteristics and craniofacial structures may be modulated by breathing pattern, and, on the other hand, that certain features may predispose to the development of the disorder. It is important to recognize these signs in order to guide further development in a more favorable direction. The results confirmed that cephalometry is a valid screening tool when assessing nasopharyngeal and retropalatal airway dimensions. Clinical examination of tonsillar size was found reliable when retroglossal airway size was evaluatedTiivistelmä Väitöskirjatyön tarkoituksena oli selvittää lasten unenaikaisten hengityshäiriöiden yhteyttä kasvojen ja leukojen kasvuun, purennan kehitykseen sekä ylempien hengitysteiden rakenteeseen. Lisäksi tutkittiin, kuinka luotettavasti hammaslääkäreiden käytössä olevin menetelmin pystytään arvioimaan lasten ahtautuneita ilmateitä. Tutkimusaineistossa oli mukana 70 lasta (36 tyttöä, 30 poikaa, ikä 4.2–11.9 vuotta), joilla diagnosoitiin unenaikainen obstruktiivinen hengityshäiriö vuosina 2000–2002. Lapsille tehtiin kliiniset tutkimukset oikojahammaslääkärin ja korva-, nenä- ja kurkkutautien erikoislääkärin toimesta sekä otettiin lateraalikallokuva ja hampaistosta kipsimallijäljennökset. Lisäksi ylempien hengitysteiden magneettitutkimus suoritettiin 36 lapselle eri pään asennoissa. Verrokkiryhmässä oli sama ikä- ja sukupuolijakauma kuin tutkimusryhmässä. Tulokset osoittivat, että unenaikaisista hengityshäiriöistä kärsivillä lapsilla horisontaalinen ylipurenta oli suurentunut, vertikaalinen ylipurenta oli pienentynyt, ylähammaskaari oli kapeampi ja alahammaskaari lyhyempi kuin terveillä verrokeilla. Alaetualueen ahtaus ja etualueen avopurenta olivat yleisempiä niillä lapsilla, joilla oli vaikeampiasteinen hengityshäiriö. Lasten unenaikaiset hengityshäiriöt liittyivät suurentuneeseen leukojen väliseen kokoepäsuhtaan, alaleuan avautuvaan kasvumalliin, pidempään ja paksumpaan pehmeään suulakeen, kieliluun alempaan asentoon, kohonneeseen pään asentoon sekä ahtaampiin nielun ilmatilan mittoihin verrattaessa terveisiin lapsiin. Häiriön vaikeusaste korreloi suurempiin poikkeamiin nielun mitoissa. Lapsilla, joilla todettiin unenaikainen hengityshäiriö, magneettitutkimukset osoittivat nielun olevan ahdas. Pään asennon vaikutukset ilmatien rakenteeseen poikkesivat unenaikaisista hengityshäiriöistä kärsivillä lapsilla. Saadut tulokset osoittivat, että hengitystapa voi vaikuttaa hampaiston, kasvojen ja leukojen rakenteiden kehitykseen. Tietyt kasvojen ja leukojen piirteet puolestaan saattavat altistaa häiriön kehittymiselle. On tärkeää tunnistaa nämä merkit, jotta kehitystä voidaan ohjata suotuisampaan suuntaan. Tutkimukset osoittivat, että kefalometrinen analyysi on luotettava arvioitaessa nenänielun sekä pehmeän suulaen takana olevan ilmatilan kokoa. Nielurisojen kliinisen koon arviointi on luotettava arvioitaessa alemman suunielun ilmatilan kokoa
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Aran, Reza. "Craniofacial morphology and sleep disordered breathing in children." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/44379.
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Objective: The aim of this study is to understand how craniofacial morphology and the severity of a malocclusion can contribute to sleep disordered breathing (SDB) symptoms in children when controlled for age, gender and body mass index (BMI).
Methods: A total of 301 subjects with complete records were included in this study. Two hundred and thirty-seven were preadolescents, of which 97 were male and 140 were female (mean age 9.9±1.6); 64 were adolescents, of which 24 were male and 40 were female (mean age 13.8±0.9). All the subjects’ parents were asked to complete a SDB questionnaire. Lateral cephalometric images were analyzed to assess the position of the hyoid bone, length of the soft palate, and the maxillary and mandibular dental and skeletal relationship. A clinical examination was performed to determine the Angle classification, Mallampati score, tonsil size (Brodesky), and BMI.
Results: Data from 301 children that completed the questionnaires and underwent a cephalometric analysis were evaluated. Subjects were divided into two groups based on their age and each group was further divided based on gender. By comparing preadolescents with adolescents we found that preadolescents presented a significantly higher incidence of hyperactivity, morning headaches, more frequent snoring, and bedwetting. Adolescents exhibited significantly higher daytime sleepiness, difficulty getting up, and impaired daytime function. When comparing female and male subjects, we found that frequent snoring, and morning headaches were more prevalent among females, while daytime sleepiness, and hyperactivity were more common among males. Craniofacial features that have a significant relationship with SDB symptoms are, a lower position of the hyoid bone, retruded mandible, steeper mandibular plane angle, and retroclined lower incisors. There was no statistically significant relationship between Angle classifications, tonsil size, Mallampati score, and BMI with SDB symptoms in this sample.
Conclusion: This study suggests that craniofacial morphology, but not severity of malocclusions, could be a potential contributing factor to SDB symptom severity.
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Kaminska, Marta. "Sleep-disordered breathing and fatigue in multiple sclerosis." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=103496.
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Fatigue is common and disabling in multiple sclerosis (MS). It is distinct from sleepiness. Both fatigue and sleepiness have been associated with sleep-disordered breathing, particularly obstructive sleep apnea (OSA) in other populations. While fatigue in MS is probably multi-factorial, OSA may play an important role. The main objectives of this project were to evaluate the relationship of OSA to fatigue and sleepiness in MS patients vs. normal controls, and to evaluate predictors of severe fatigue in MS subjects. Stable, ambulatory MS patients without known sleep disorders were recruited from the Montreal Neurological Hospital MS clinic. Normal controls were age and sex frequency-matched. All participants underwent diagnostic overnight polysomnography and a multiple sleep latency test (objective measure of daytime sleepiness). Fatigue was measured with the Fatigue Severity Scale (FSS) and the Multidimensional Fatigue Inventory (MFI), and subjective sleepiness with the Epworth Sleepiness Scale (ESS). Covariates included age, sex, body mass index, MS disability level, depression, pain and restless legs syndrome severity. OSA, defined as an apnea-hypopnea index (AHI) ≥ 15, was found in 36 of 62 (58%) MS subjects and 15 of 32 (47%) control subjects – OR (95% CI) 1.57 (0.67, 3.74). After adjusting for confounders, severe fatigue (FSS > 5) and the MFI-mental fatigue scale (> group median) were associated with AHI and respiratory-related arousals, in MS but not in control subjects. MFI-mental fatigue, in MS subjects, was also associated with intermittent hypoxemia. Subjective and objective sleepiness were not related to OSA in either group. In a multivariate model for MS subjects alone, the significant predictors of severe fatigue were the MS disability level – OR (95% CI) 1.88 (1.18, 3.33) and severe OSA (AHI ≥ 30) – OR (95% CI) 19.55 (2.31, 322.09). In summary, while OSA was not more frequent in MS than in control subjects, it was associated with severe fatigue only in MS subjects. No association was found with sleepiness. Severe fatigue in MS subjects showed a marked association with severe OSA, and a less pronounced association with MS disability level. In that OSA is a treatable condition, these findings open the door to further research that may lead to important changes in management of severely fatigued MS subjects.La fatigue est fréquente et incapacitante dans la sclérose en plaque (SP). Elle est distincte de la somnolence. La fatigue et la somnolence ont été associées aux troubles respiratoires du sommeil, particulièrement à l'apnée obstructive du sommeil (AOS). La fatigue dans la SP est vraisemblablement multifactorielle, mais l'AOS pourrait y jouer un rôle important. Les principaux objectifs de ce projet étaient d'évaluer le rapport entre l'AOS et la fatigue ainsi que la somnolence chez les patients atteints de SP comparativement au sujets témoins, et d'évaluer les facteurs associés à la fatigue sévère chez les sujets atteints de SP. Des patients atteints de SP stables et ambulatoires sans troubles du sommeil connus ont été recrutés à la clinique de SP de l'Hôpital Neurologique de Montréal. Le groupe de sujets contrôle a été assorti en âge et sexe. Tous les participants ont passés une polysomnographie diagnostique et un test itératif de latence à l'endormissement (mesure objective de la somnolence diurne). La fatigue fut mesurée par la 'Fatigue Severity Scale' (FSS) et le 'Multidimensional Fatigue Inventory' (MFI), et la somnolence subjective avec l'échelle de somnolence Epworth (ESS). Les autres variables étaient l'âge, le sexe, l'indice de masse corporel, le niveau d'incapacité lié à la SP, la dépression, la douleur et la sévérité du syndrome des jambes sans repos. L'AOS, défini par un indice d'apnée-hypopnée (IAH) ≥ 15, a été retrouvée chez 36 des 62 (58%) sujets SP et 5 des 32 (47%) sujets témoins – rapport de cote (RC, IC 95%) 1.57 (0.67, 3.74). Après ajustement pour les facteurs confondants, la fatigue sévère (FSS > 5) et le MFI – fatigue mentale (> médiane du groupe) étaient associés avec l'IAH et les micro-éveils respiratoires, chez les sujets SP mais non chez les sujets contrôle. Le MFI – fatigue mentale, chez les sujets SP, était aussi associé à l'hypoxémie intermittente. Ni la somnolence subjective, ni objective n'étaient associées à l'AOS dans aucun des 2 groupes. Dans un modèle à plusieurs variables pour les sujets SP seulement, les seules variables prédisant la fatigue sévère étaient le niveau d'incapacité – RC (IC 95%) 1.88 (1.18, 3.33) et l'AOS sévère (IAH ≥ 30) – RC (IC 95%) 19.55 (2.31, 322.09). En résumé, quoique l'AOS n'aie pas été plus fréquente dans la SP que chez les sujets témoins, elle était associée à la fatigue sévère chez les sujets SP seulement. Aucune association avec la somnolence n'a été mise en évidence. La fatigue sévère chez les sujets SP était associée de façon marquée à l'AOS sévère, et de façon moins prononcée au niveau d'incapacité. Comme l'AOS est une condition qui se traite, ces résultats ouvrent la porte à des recherches plus poussées qui pourraient ultérieurement changer la prise en charge des patients atteints de SP avec fatigue sévère.
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Johnston, Christopher David. "Sleep-disordered breathing : a cephalometric and clinical study." Thesis, Queen's University Belfast, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313925.
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Waters, Karen Ann. "Sleep disordered breathing and its treatment in children." Thesis, The University of Sydney, 1993. https://hdl.handle.net/2123/26603.
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The establishment of a dedicated paediatric sleep unit over the past three years has allowed detailed investigation of a large number of children with sleep associated upper airway obstruction. This thesis explores the characteristics of upper airway obstruction and sleep associated breathing control abnormalities, in children who have been investigated in that unit. The "unit" began with three or four people performing children’s sleep studies at the Sleep Unit (for adults) at RPAH; the results presented here include those studies. The methods used in this thesis have evolved through practical experience acquired in caring for children with breathing disorders in sleep.
This thesis is presented in two parts. The studies in the first section provide an overview of the presentation and treatment of the syndrome of obstructive sleep apnoea (OSA) as it occurs in infants and children. The second section is a more detailed exploration of OSA and its treatment in achondroplasia. These latter studies provide further insights into the disorder in this specific group, and therefore into some aspects of OSA in the broader population of children.
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Costa, Carolina Marins Ferreira da. "Influência do tratamento da respiração oral na sintomatologia de crianças com Transtorno do Déficit de Atenção/Hiperatividade." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5138/tde-21062007-144844/.
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INTRODUÇÃO: A literatura confirma a relação existente entre os Distúrbios Respiratórios do Sono (DRS) e os sintomas do Transtorno do Déficit de Atenção/Hiperatividade (TDAH). Há estudos que mostram o efeito dos tratamentos para DRS no comportamento, observando-se, após adenotonsilectomia, melhora nos índices dos testes de comportamento, assim como no desempenho escolar das crianças com TDAH. Considerando-se a relação existente entre a Respiração Oral (RO) e os DRS e entre estes e o TDAH, pretende-se avaliar se ocorrem interferências sintomáticas entre a RO e o TDAH, quando se obtém a reversão da RO em respiração nasal fisiológica, através da utilização do tratamento ortopédico funcional (utilização de placas ortopédicas, orientação para o fechamento labial, ginástica respiratória) e terapia fonoaudiológica. MÉTODOS: Neste estudo longitudinal, realizado entre janeiro de 2004 e janeiro de 2007, acompanhando pacientes com TDAH e RO, de 7 a 13 anos de idade, por 18 meses, no ambulatório de TDAH do Hospital das Clínicas/ FMUSP, comparamos os escores de testes comportamentais para TDAH (Conners e SNAP IV) em dois grupos de pacientes que estavam sendo tratados com metilfenidato, um dos quais recebeu tratamento ortopédico funcional e fonoaudiológico para a RO. RESULTADOS: 1) Não houve diferenças entre o grupo tratado e não tratado para a RO com respeito à idade; 2) Os escores dos questionários no grupo tratado para RO foram significantemente diminuindo (indicando melhora) em todas as variáveis (exceto Conners Pais -conduta anti-social), ao longo do tempo; 3) Os escores dos questionários no grupo tratado para RO foram significantemente menores (indicando melhora) do que os escores do grupo não tratado, para todas as variáveis estudadas, quando se comparam os dois grupos; 4) Esta melhora dos sintomas ocorreu após 12 meses de tratamento para RO e persistiu aos 18 meses; 5) dois dos oito pacientes do grupo tratado puderam interromper o metilfenidato, sendo que todos os pacientes do grupo não tratado ainda utilizam o medicamento. CONCLUSÕES: O Tratamento Ortopédico Funcional para RO, em conjunto com a terapia fonoaudiológica, foi efetivo para a melhora dos sintomas de TDAH em pacientes em tratamento com metilfenidato; a RO e os DRS devem ser investigados e tratados em pacientes com diagnóstico ou suspeita de TDAH, pois podem contribuir para a piora dos sintomas.INTRODUCTION: A number of studies demonstrate the relationship between Sleep Respiratory Disorders (SRD) and symptoms of the Attention Deficit Hyperactivity Disorder (ADHD). Some of them assess the effect of the treatments for SRD on the behavior; for example, an improvement of the scores in the behavior tests, as well as in the school performance of children with TDAH is observed after adenotonsillectomy Considering the relation between mouth breathing (MB) and SRD and between these and the ADHD, we aimed to evaluate symptomatic interferences between MB and ADHD, through the reversion of MB in physiological nasal breath, by means of functional orthopedics treatment (use of orthopedics plates, orientation for labial closing, respiratory gymnastics) and speech therapy. METHODS: In this longitudinal study, performed between January of 2004 and January of 2007, 16 patients with ADHD and MB, aged 7 to 13 years, and who were being treated with methylphenidate, were followed-up for 18 months, in the outpatient clinic for ADHD at the Hospital das Clínicas da FMUSP. We compared the scores in ADHD tests (Conners and SNAP IV) of two groups of eight patients, one of which received functional orthopedics treatment and speech therapy for MB and the other did not. RESULTS: 1) The two groups were statistically equivalent by age; 2) The scores of the questionnaires in the group of patients treated for MB were significantly lowering (indicating improvement) regarding all the variables (except Conners Parents - antisocial behavior), along the follow-up period; 3) The scores of the questionnaires in the treated group were significantly lower (indicating improvement) of the scores in no treated group, for all the studied variables, when the two groups are compared; 4) This improvement of the symptoms occurred 12 months after the beginning of the treatment for MB and persisted at 18 months; 5) two of the eight patients from the treated group were indicated for interrupting the methylphenidate; however, all patients of the group not treated were still utilizing the medication. CONCLUSIONS: Functional the Orthopedics Treatment for MB, associated with speech therapy, was effective for the improvement of the symptoms of ADHD in patients who were being treated with methylphenidate; MB and SRD must be investigated and treated in patients with diagnosis or suspicion of ADHD, as they can contribute for the worsening of the symptoms.
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Bruyneel, Marie. "Ambulatory diagnostic and monitoring techniques for sleep disordered breathing." Doctoral thesis, Universite Libre de Bruxelles, 2015. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/216824.
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Techniques ambulatoires de diagnostic et de monitoring des troubles respiratoires liés au sommeil.Le syndrome d’apnées obstructives du sommeil (SAOS) est un trouble du sommeil très fréquent, fortement lié à l’obésité, ce qui explique sa prévalence en pleine expansion. En parallèle, la demande d’examens polysomnographiques (PSG) en laboratoire du sommeil, méthode diagnostique de référence, est en croissance. Comme l’accès à cette technique est peu aisé, de nombreux appareils simplifiés d’enregistrement de sommeil ont été récemment développés, mais restent imparfaits (mauvaise évaluation du temps de sommeil, sous-estimation de la sévérité du SAOS, faux négatifs, taux d’échec élevé) et sont d’un apport limité pour le diagnostic du SAOS. La PSG au domicile (PSG-d) est une alternative bien plus informative, permettant d’éviter nombre des désavantages rencontrés par l’usage d’appareils simplifiés. Nous l’avons dès lors étudiée pour le diagnostic du SAOS, au travers d’une étude randomisée comparant la PSG-d vs la PSG hospitalière. En termes d’efficacité diagnostique, les résultats sont excellents, avec un faible taux d’échec d’examens à domicile (4.7 vs 1.5%). Les patients préfèrent être enregistrés dans leur propre environnement où la qualité de leur sommeil est d’ailleurs meilleure. Nous avons ensuite voulu faire le point sur la littérature récente au travers d’un article de revue, en analysant les études prospectives randomisées comparant la PSG-d et au labo du sommeil. Les résultats de ces études concordent pour démontrer que la PSG-d constitue une excellente alternative aux tests réalisés à l’hôpital. Outre le SAOS, l’outil permet le diagnostic d’autres troubles du sommeil, comme les mouvements périodiques des jambes durant le sommeil, les troubles du rythme circadien, Une question restée jusqu’ici sans réponse était l’influence de la localisation du branchement des PSG-d, à l’hôpital ou à domicile. Une étude prospective randomisée nous a permis d’établir que la localisation du branchement des PSG-d n’influençait pas la qualité globale de l’examen, ce qui simplifiera l’utilisation de cet outil à l’avenir. Enfin, nous avons utilisé des techniques de télé monitoring (TM) pour contrôler, en temps réel, la qualité des PSG-d. Dans une première étude pilote, la faisabilité a été confirmée, malgré quelques difficultés techniques. Nous avons voulu appliquer la technique à une population de patients souffrant d’un syndrome coronarien aigu, incapables d’être enregistrés au labo du sommeil. Nous avons étudié la qualité du screening du SAOS par PSG vs polygraphie (PG). Les résultats se sont révélés surprenants :82% de cette population présentait des troubles respiratoires liés au sommeil, principalement centraux. La PSG était nettement plus sensible que la PG, et le TM améliorait la qualité des PSG. Chez les patients traités pour SAOS, nous avons ensuite utilisé un outil de monitoring, l’actigraphie (Act), afin d’observer, dans la vie de tous les jours, les changements de schémas de sommeil et d’activité physique engendrés par la pression positive continue (PPC). Dans un premier travail, rétrospectif, nous avons observé ces paramètres chez des SAOS avant traitement, puis au travers d’une étude prospective multicentrique, nous avons suivi 150 patients avant et après PPC, et observé chez eux une augmentation de temps de sommeil, mais pas de l’activité physique. En conclusion, nous avons démontré dans cette thèse l’intérêt clinique de deux excellents outils ambulatoires, la PSG-d et l’Act, pour la prise en charge du SAOS. Les implications potentielles sont une meilleure accessibilité diagnostique pour le SAOS, une initiation thérapeutique plus précoce et un suivi plus précis des SAOS traités, dans des conditions ambulatoires, plus confortables et plus adéquates pour les patients.Ambulatory diagnostic and monitoring techniques for sleep disordered breathingSleep disordered breathing (SDB), including obstructive sleep apnea syndrome (OSAS), is directly related to obesity. Significant morbi-mortality is associated with OSAS, explaining the increasing demand for in-hospital polysomnography (PSG), the reference diagnostic method. As this technique is complex and time-consuming, many simplified portable monitoring (PM) devices for home sleep testing have been developed. However, the ability of PM devices to detect OSA remains limited: sleep time is not correctly assessed, OSA severity is underestimated, false negative results occur and the failure rate of the tests is high, up to 30%. Home-PSG (H-PSG) is an interesting alternative, avoiding many of these drawbacks. In the first part of this work, we studied the tool in an original study comparing H-PSG and in-lab PSG. Diagnostic efficacy was good and the failure rate low (4.7 vs 1.5%). Patients slept in their own environment and thus sleep quality was better. We were then interested by reviewing recent literature data regarding prospective randomised trials comparing H-PSG and in-lab PSG. We concluded that H-PSG is an excellent alternative for in-lab PSG, allowing not only OSA detection but also diagnosis of a large panel of other sleep disorders (periodic leg movements during sleep, circadian disorders,). As the best place to perform set-up for H-PSG remained unknown, we studied, in another prospective randomised study, the recording’s quality obtained in both settings. As no difference was observed, lab set up was found to be the simpler option for performing H-PSG. We then tested, in a prospective pilot study, real-time telemonitoring (TM) of H-PSG in order to enhance recording quality. Results were encouraging but we faced some technical problems. In a second study, we applied TM coupled with PSG to detect SDB in acute coronary syndrome, in patients too unstable to come in the sleep lab. We compared also PSG results to polygraphy (PG). Surprisingly, 82% of patients suffered from SDB. PSG was much more sensitive than PG to screen SDB in this population and TM improves recording quality. In the second part of this work, we have used actigraphy (Act) to assess sleep and physical activity in OSA patients in real-life conditions. Firstly, in a retrospective study, we documented these parameters before treatment. In a second multicentre study, we evaluated the changes in sleep schemes and physical activity under continuous positive airway pressure (CPAP) in 150 OSA patients. We observed that sleep time was increased under CPAP, but physical activity was not improved, contrarily to sleepiness and quality of life. In conclusion, we have shown through these works the clinical interest of two excellent ambulatory tools, H-PSG and Act, for OSA management. Potential clinical implications include enhanced healthcare accessibility, earlier treatment initiation and a closer follow-up of treated patients, through ambulatory tools, in a comfortable environment for the patients.
Doctorat en Sciences médicales (Médecine)
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Wang, David. "Sleep disordered breathing in stable methadone maintenance treatment patients /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002992.
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Ross, Kristie R. "Sleep Disordered Breathing, Obesity, and Asthma Severity in Children." Case Western Reserve University School of Graduate Studies / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1291296902.
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Nahapetian, Ryan, Graciela E. Silva, Kimberly D. Vana, Sairam Parthasarathy, and Stuart F. Quan. "Weighted STOP-Bang and screening for sleep-disordered breathing." SPRINGER, 2015. http://hdl.handle.net/10150/623579.
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STOP-Bang is a tool for predicting the likelihood for sleep-disordered breathing (SDB). In the conventional score, all variables are dichotomous. Our aim was to identify whether modifying the STOP-Bang scoring tool by weighting the variables could improve test characteristics.
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Ward, Neil Robert. "Diagnosis of sleep-disordered breathing in chronic heart failure." Thesis, Imperial College London, 2011. http://hdl.handle.net/10044/1/9597.
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Sleep-disordered breathing (SDB) is prevalent but underdiagnosed in chronic heart failure (CHF). The aim of this thesis was to investigate the utility of simple portable monitoring and clinical features to identify CHF patients with SDB. In addition, the influence of scoring criteria on diagnosis and classification of SDB in CHF was investigated. In the first study, clinical characteristics in CHF patients with SDB were compared to those without SDB. No specific symptom, anthropometric characteristic or measure of heart failure severity was reliably able to identify CHF patients with SDB. In the second study, the accuracy of heart rate variability (HRV) analysis and overnight pulse oximetry for diagnosis of SDB in CHF were investigated. The percent very low frequency increment (%VLFI) of HRV had low accuracy for diagnosis of SDB. In contrast, the >3% oxygen desaturation index measured by pulse oximetry had a high diagnostic accuracy, with sensitivity 0.97 and negative likelihood ratio 0.08 at a prespecified cutoff of >7.5 desaturations per hour. In the third study, the impact of hypopnoea scoring criteria on SDB diagnosis in CHF was evaluated. The prevalence of SDB changed significantly from 29% when hypopnoeas were scored with a corroborative ≥4% oxygen desaturation, to 46% when hypopnoeas were scored with a corroborative ≥3% oxygen desaturation or arousal from sleep (p<0.001). Respiratory event scoring criteria did not influence the classification of SDB as obstructive or central sleep apnoea. In summary, this thesis has shown that clinical features and HRV analysis can not be used to identify CHF patients with SDB. Overnight pulse oximetry has a high diagnostic accuracy and would be of greatest clinical use to rule out SDB in patients with CHF. The criteria used to score respiratory events during sleep studies can have a significant impact on the diagnosis and prevalence of SDB in CHF.
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Theorell-Haglöw, Jenny. "Sleep and Sleep-disordered Breathing in Women : Associations with Daytime Symptoms and Metabolism." Doctoral thesis, Uppsala universitet, Lungmedicin och allergologi, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-99080.
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Obstructive sleep apnea (OSA) is characterized by snoring, apneas and excessive daytime sleepiness (EDS). Although commonly present in OSA, factors relating to daytime sleepiness are not fully elucidated. OSA is associated with obesity and with cardiovascular disease, type 2 diabetes mellitus and the metabolic syndrome. In this population-based study 7,051 women answered a questionnaire on sleep and health. Psychological distress, insomnia and somatic disease were the factors most strongly related to both EDS and fatigue independent of other factors. Snoring was independently associated with both EDS and fatigue, but the associations were relatively weak. In addition, 400 of the women underwent polysomnography and an oral glucose tolerance test. OSA was associated with changes in glucose metabolism independently of confounders such as central obesity. Moreover, low minimal saturation was independently associated with reduced insulin sensitivity. In women sleeping <6-7 hours there was a substantial increase in waist circumference and short sleep duration remained associated with central obesity, even after adjusting for body mass index (BMI). The most pronounced negative influence of short sleep duration and also reduced duration of slow-wave sleep (SWS) or rapid eye movement (REM) sleep was seen in women <50 years. All measures of OSA were related to the metabolic syndrome after adjustments. In addition, the relationship remained after adjusting for central or general obesity. Hypoxia was independently associated with hypertriglyceridemia, even after adjusting for BMI. In conclusion, OSA may have significant impact on insulin sensitivity and metabolism in women, and the relationship could, to some extent, be mediated through hypoxia. Moreover, reduced sleep duration and loss of SWS and REM sleep may influence central obesity; a strong risk factor for OSA. Daytime sleepiness was most strongly related to psychological distress, insomnia and somatic disease although snoring was also a risk factor. This finding indicates that sleep apnea is only one factor contributing to daytime sleepiness in women.
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Bates, Claire J. "The management of sleep-related breathing disorders utilising mandibular repositioning splints." Thesis, University of Edinburgh, 2006. http://hdl.handle.net/1842/24975.
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This prospective cross sectional cohort study examined management of sleep related breathing disorders with mandibular repositioning splints (MRS). There aspects were examined; 1. The relationship between severity of sleep related breathing disorders and lateral cephalometric radiograph values. 2. Patients’ perspectives on treatment of sleep disordered breathing with a mandibular repositioning splint. 3. Comparisons of treatment success with severity of sleep disordered breathing and patients anatomical dimensions. One hundred and twenty one lateral cephalometric radiographs were traced under uniform conditions and a series of 56 landmarks identified, from which 48 angular and linear measurements were made. Significant differences were seen when comparisons of these measurements with the severity of sleep related breathing disorders were investigated. Body Mass Index, the Maxillary-Mandibular Plane angle and the pharyngeal dimension increased significantly in some subjects as Epworth Sleepiness Score (ESS) increased in severity. Overjet, lower lip length, and the distance from the Hyoid bone to B point on the mandible increased significantly in some subjects as OSAHS, as measured by the Apnoea/Hypopnoea Index (AHI), increased in severity. The Hyoid bone was found to rotate counter clockwise as severity of AHI increased, as a result the distance between the most anterior superior point on Hyoid bone and the maxillary plane was seen to decrease as severity of AHI increased. Investigation of patients and sleeping partners perspectives on treatment was undertaken with the use of a questionnaire based study. ESS score for both patents and partners decreased significantly after treatment, but the mean decrease was not clinically significant. No correlation was found between AHI and ESS score. No predictors for success or failure of treatment were found.
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Lazareck, Lisa. "Investigation of breathing-disorderd sleep qualification using the oxygen saturation signal." Thesis, University of Oxford, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490099.
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This thesis investigates the feasibihty of using the non-invasive biomedical signal of oxygen saturation, or Sp02, to diagnose a sleep disorder known as Obstructive Sleep Apnoea Hypopnoea Syndrome (OSAHS). Epidemiologically, OSAHS is the most common condition investigated by sleep clinics. In a patient suspected of having the disorder, the upper airway is obstructed during sleep and a cessation in respiration results.
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Nau, Jeffrey A. "Association Between Age-Related Macular Degeneration and Sleep-Disordered Breathing." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3463.
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Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health and Nutrition Examination Survey to study whether there was an association between SDB and AMD, including neovascular AMD and geographic atrophy in adults 40 years and older. Descriptive statistics and logistic regression analyses were used. The results suggest that AMD is associated with diagnosed sleep disorders, including sleep apnea and insomnia, as well as sleep apnea symptoms of gasping snoring, snorting, and stopping breathing. The findings of this study highlight the importance of diagnostic screening and therapeutic intervention to treat SDB. Early diagnosis and therapy for SDB could address not only the comorbidities associated with SDB, but could also prevent or slow the progression of AMD. In turn, this would yield lower rates of vision loss, reduced comorbidities associated with vision loss, and reduced impact of AMD on the health care system and social and financial costs to society.
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Chien, Jimmy Kin Yuen. "The Role of Surface Tension of Upper Airway Lining Liquid and Breathing Route in Sleep Disordered Breathing." Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/15339.
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This thesis examines the relationship between surface tension in the upper airway liquid, breathing route, and sleep disordered breathing. Upper airway surface tension values were examined in both healthy subjects and in those with obstructive sleep apnoea. To determine whether the enforced oral breathing route induced sleep disordered breathing via surface tension mediated mechanisms, healthy subjects were given exogenous surfactant with enforced oral route of breathing during sleep. The relationship between uncontrolled route of breathing and surface tension was then examined in subjects with severe obstructive sleep apnoea. Finally, exogenous surfactant and normal saline were administered to subjects to determine the presence of any therapeutic effect on obstructive sleep apnoea. The studies in this thesis i) described a range of surface tensions in healthy subjects, and in those with OSA, ii) investigated the role of breathing route on upper airway surface tension and OSA severity, and iii) investigated the role of exogenous surfactant as a therapeutic agent in both oral breathing induced sleep disordered breathing (in healthy subjects) and in subjects with mild to moderate obstructive sleep apnoea.
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Ali, Nabeel Jawad. "The epidemiology and consequences of sleep and breathing disorders in young children." Thesis, University of Southampton, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264889.
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Azimi, Hilda. "Pressure Sensitive Mat: An Alternative Sensor to Detect Sleep-Related Breathing Disorders." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/41500.
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Abstract
Sleep Apnea (SA) is a common disorder that affects approximately 2% of middle-aged women and 4% of middle-aged men. It is characterized by repetitive cessation of breathing during sleep. SA has significant health and social consequences such as daytime sleepiness, impaired quality of life, and in the worst case, myocardial infarction and sudden cardiac death. It has been estimated that approximately 80% of individuals with moderate to severe SA syndrome have not been diagnosed. The lack of patient sleep histories has caused low identification of SA and referral rates, especially in primary care facilities. Moreover, due to the inadequate prevalence of overnight polysomnography (PSG) as a standard clinical test of SA, patients suspected of having this sleep disorder have to wait several months for diagnosis and treatment.
The costly and time-consuming nature of PSG and the lack of sleep clinics have created a demand for suitable home-based health monitoring devices. Over the years, several devices have been developed to monitor sleep unobtrusively, while an individual is lying in bed. However, most of these devices would either disrupt the sleep of the patient or be disrupted by the patient during routine bed sheet changes. Pressure measurement using a Pressure Sensitive Mat (PSM) enables a non-contact approach for monitoring patient vital signs such as respiration rate. The PSM has the potential to replace obtrusive breathing sensors in the sleep lab and to be used as a pre-screening tool for patients suspected of having sleep apnea.
This thesis proposes multiple algorithms applicable to PSM in order to assess sleep quality. First, fusion techniques are proposed to extract a breathing signal from PSM. Second, a wide range of machine learning approaches including a simple threshold-based algorithm, a linear support vector machine (SVM) and two deep learning methods (i.e., a temporal convolutional network (TCN) and a bidirectional long short-term memory (BiLSTM) network) are compared to find a good-
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performing method for automatically detecting central sleep apnea (CSA) events from PSM signals. The results show that the accuracy of the model with the best performance is 95.1% and it is achieved by the BiLSTM network. Finally, by applying SVM, personalized systems are optimized to investigate long-term sleep pattern changes such as central apnea index (CAI), bed occupancy (BO), day-clock, and night-clock from previously recorded data.
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Vazir, Ali. "Prevalence and characteristics of sleep disordered breathing in mild heart failure." Thesis, Imperial College London, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.437371.
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Brady, Emer Margaret. "Investigating the relationship between sleep disordered breathing, glycaemic control and inflammation." Thesis, University of Leicester, 2009. http://hdl.handle.net/2381/9926.
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Metabolic Syndrome (MetS), Type 2 Diabetes (T2DM) and obesity related sleep disorders like Sleep Disordered Breathing (SDB) share common features including visceral adiposity, impaired glycaemic control and increased cardiovascular disease (CVD) risk. As sub-clinical inflammation is considered a key player in these conditions they are thought to be interrelated. We aimed to further investigate this putative interrelationship. In a multi-ethnic population with a spectrum of glucose tolerance (sub-study of the ADDITION-study), we report that abdominal obesity underpins the association between SDB and systemic inflammation. South Asians with SDB had significantly higher levels of leptin, poorer glycaemic control but lower levels of oxidative stress than their Caucasian counterparts. These data suggest that the pathogenesis of SDB is different between these ethnic groups and may aid in understanding why South Asians are at increased risk of T2DM and CVD. Furthermore, SDB is independently associated with increased likelihood of MetS. However, no differences in cardiovascular markers, inflammatory biomarkers or anthropometric measures were observed between those with excessive daytime sleepiness or sleep disturbances as determined by the Epworth Sleepiness Scale and the Sleep Assessment Questionnaire, respectively. This suggests that these questionnaires are broad and insensive in identifying these sleep parameters. Obstructive Sleep Apnoea (OSA) is a severe form of SDB which can be successfully treated with Continuous Positive Airway Pressure (CPAP). Reported results on the effects of CPAP therapy on glycaemic control are inconsistent thus no difinative conclusion could be made from the systematic review carried out to answer this research question. Thus 'The Leicester Sleep and Sugar Study' was conducted to further establish whether CPAP-therapy impacts glycaemic control or systemic inflammation in subjects with established T2DM and newly diagnosed OSA. We report a clinically significant improvement in glycaemic control (HbA1c -0.8%) and a significant reduction in waist circumference with improved psychological well being 6 months post CPAP-therapy. It is evident that OSA is associated with T2DM and MetS although the direction of cause and effect has not been elucidated to date. The results reported here suggest that OSA negatively impacts on glycaemic control. Additionally we report a possible ethnic difference in the pathophysiology of SDB with inflammation playing a key role. Further research is required in this area to further establish these findings.
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Atalla, Angela. "Sleep disordered breathing in chronic heart failure : causes, consequences and treatment." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/11672.
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Chronic heart failure (HF) is a prevalent clinical syndrome in which both central and obstructive sleep disordered breathing (SDB) have been described. The aim of this research was to investigate the mechanisms causing central SDB, their consequences with reference to sleep and physical activity, and the way in which treatment modalities may modify these. The first study of this thesis is the SERVE-HF study, a randomised controlled trial of adaptive servoventilation (ASV) to treat central SDB in patients with CHF. This study is ongoing and aims to test the hypothesis that patients randomised to ASV will have a reduction in mortality compared to controls. Data regarding those randomised at the Royal Brompton Hospital are presented alongside data on ventilator compliance in the ASV group. The second study investigated ventilatory control, in HF patients both with and without SDB. It tested the hypothesis that those with central SDB had heightened chemosensitivity (assessed by the hypercapnic ventilatory response, HCVR) compared to those with no SDB and older healthy controls. The third study explored the effect of treatment on ventilatory control by testing the hypothesis that the implantation of a cardiac-resynchronisation therapy pacemaker would be associated with a reduction in the HCVR from baseline to 3 months post implantation. The fourth study investigated the consequences of SDB in CHF. Physical activity, subjective sleepiness and sleep were assessed in patients with CHF and older healthy controls to test the hypothesis that physical activity would be reduced in those with central SDB compared to those without SDB, and reduced in both patient groups compared to the controls. In summary, this thesis investigated the mechanisms underlying central SDB in patients with HF, to elucidate their consequences, both by day and night and to address the ways in which treatment modalities may modify these pathophysiological mechanisms. [For supplementary files please contact author].
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Kimura, Kaku. "Sleep-disordered breathing at an early stage of amyotrophic lateral sclerosis." Kyoto University, 1999. http://hdl.handle.net/2433/181697.
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kuo, Tracy F. "Sleep-disordered breathing (SDB) and neuropsychological function: A community sample study." Diss., The University of Arizona, 2000. http://hdl.handle.net/10150/284215.
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This is a case-control study investigating the relationship of sleep-disordered breathing (SDB) to neuropsychological functioning. Participants were recruited from the Tucson Sleep Heart Health Study (SHHS), which is a population-based study examining cardiovascular consequences of SDB. A sample of 103 men and women, ages 40-75, consisting of 51 controls (CTL group) and 52 persons with SDB (SDB group), matched by age (± 5 years) and sex, was enrolled. CTL subjects had a respiratory disturbance index (RDI), a measure of SDB, ≤ 5 while the SDB subjects had a RDI 20 to 50, inclusive. All participants had an overnight in-home polysomnography (PSG) prior to undergoing a neuropsychological evaluation. Psychological functioning was assessed and the areas of cognitive functioning that were tested included general intelligence, attention and working memory, psycho-visuo-motor efficiency, manual dexterity, and frontal/executive function. The SDB group performed significantly worse on the Stroop Color-Word test, made more errors on the Controlled Oral Word Association test, and overestimated time elapsed. The SDB group also demonstrated a statistical trend ( p ≤ 0.10) for worse performance on Wechsler Adult Intelligence Scale - III Digit Span, Letter-Number Sequencing and Digit Symbol Coding subtests, and the non-dominant hand performance on the Grooved Pegboard. Factor analyses were performed to reduce the number of neuropsychological variables and measures of SDB. Controlling for IQ, multiple regression analyses showed a significant negative association between a "nocturnal hypoxemia" factor and both "manual dexterity" and "semantic memory" factors. The results suggest that persons with moderate SDB, compared to controls, did not report increased depression or other aspects of psychological distress. SDB is, however, associated with subtle neuropsychological decrements in frontal/executive function, psycho-visuo-motor efficiency, and working memory. The performance decrement in tasks of frontal executive function and manual dexterity was primarily associated with nocturnal hypoxemia and not to the frequency of sleep fragmentation.
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Lazareck, Lisa. "Investigation of breathing-disordered sleep quantification using the oxygen saturation signal." Thesis, University of Oxford, 2008. https://ora.ox.ac.uk/objects/uuid:63671d89-e3a4-49e6-a486-3f605cacd1c1.
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This thesis investigates the feasibility of using the non-invasive biomedical signal of oxygen saturation, or SpO2 , to diagnose a sleep disorder known as Obstructive Sleep Apnoea Hypopnoea Syndrome (OSAHS). Epidemiologically, OSAHS is the most common condition investigated by sleep clinics. In a patient suspected of having the disorder, the upper airway is obstructed during sleep and a cessation in respiration results. An apnoea is defined as a temporary cessation of breathing. Similarly, a hypopnoea is defined as any reduction in breathing (i.e., less severe than an apnoea). The work has three main objectives; the first being to establish automated evaluation procedures for methods of quantifying apnoeic activity from the SpO2 signal, the second being to accurately identify apnoeic and normal activity on a minute-by-minute basis, the third being to create a Respiratory Disturbance Index (RDI) based on the analysis which is comparable to the gold-standard Apnoea Hypopnoea Index (AHI) derived by experts. The detection of apnoeic activity is determined using three separate analyses: time domain, frequency domain, and autoregressive modelling with an incorporated amplitude criterion. A training dataset is utilised for algorithm development, and an independent dataset is employed for testing . All three methods result in comparable overall classification accuracies of: 81.2% (time domain), 82.1% (frequency domain), and 80.0% (autoregressive modelling with amplitude). In addition, particular attention is given to the resultant sensitivity, specificity, and accuracy values partitioned according to patient category; i.e., patients with OSAHS may be divided into normal, mild, moderate and severe. Lastly, a simple RDI is computed based on the automated analyses; i.e., the number of apnoeic segments detected divided by the total number of segments used. A comparison between computed RDI and AHI values for the test database show correlation values above 0.8. In conclusion, this thesis shows that through the automated analysis of the SpO2 signal, OSAHS severity in patients suspected of having the disorder can be quantified. The AR-modelling with an incorporated amplitude criterion, in particular, shows the most promise for further work in this area.
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Johal, Ama. "Mandibular advancement splint therapy and sleep nasendoscopy in subjects with sleep-related breathing disorders : a clinical trial." Thesis, Queen Mary, University of London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.542008.
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Mahadevan, Anandi. "Ischemic Feature Identification and Its Relation to Sleep Disordered Breathing in Sleep Heart Health Study Subjects." University of Akron / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=akron1384984982.
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Harbison, Joseph Augustine. "The course, associations and clinical significance of sleep disordered breathing following stroke." Thesis, University of Newcastle upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270779.
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Cohen, Jeffrey M. "Sleep Disordered Breathing and Sleep Duration and the Risk of Psoriasis and Melanoma in the United States." Thesis, Harvard University, 2015. http://nrs.harvard.edu/urn-3:HUL.InstRepos:15821589.
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Sleep disordered breathing (snoring and obstructive sleep apnea (OSA)) has been associated with negative health outcomes including diabetes mellitus, cardiovascular disease, and reduced quality of life, presumably due to systemic inflammation. Long and short sleep duration have been associated with morbidity, all-cause mortality, and cancer-specific mortality. No large prospective studies exist to explore the relationship between sleep disordered breathing and sleep duration and psoriasis and melanoma risk.
This study prospectively evaluated the association between OSA and snoring and incident psoriasis in the Nurses’ Health Study (NHS; 1997-2008) and the association between sleep duration and melanoma risk in the NHS (1986-2012), NHS II (2001-2009), and Health Professionals Follow-Up Study (HPFS; 2000-2012). Cox proportional hazards were used to calculate age-adjusted and multivariate risk ratios.
Over the follow-up period, there were 524 cases of psoriasis among the women who were assessed for sleep apnea. Women with OSA were more likely to have a higher BMI, be hypertensive, work night shifts, and have type 2 diabetes mellitus. The age-adjusted relative risk (RR) of psoriasis among women with OSA was 2.19 (95% CI, 1.39-3.45). The multivariate RR adjusting for night shift work and hypertension, cardiovascular disease, and type 2 diabetes mellitus was 1.91 (95% CI, 1.20-3.05). There was no effect modification by BMI (p=0.52), hypertension (p=0.34), or snoring (p=0.91). Sleep apnea was not associated with an increased risk of psoriatic arthritis. Although women with sleep apnea were more likely to be snorers, we did not find a statistically significant relationship between snoring and psoriasis risk.
In the three cohorts, there was no relationship between sleep duration and melanoma risk. The multivariate RRs were 0.90 (95% CI, 0.67-1.20) for ≤6 hours, 1.30 (95% CI, 1.08-1.56) for 8 hours, and 0.76 (95% CI, 0.51-1.12) for ≥9 hours (p trend=0.09) in the NHS and NHS II and 1.08 (95% CI, 0.77-1.51) for ≤6 hours, 0.95 (95% CI, 0.69-1.30) for 8 hours, and 1.06 (95% CI, 0.68-1.67) for ≥9 hours (p trend=0.71) in the HPFS. In the NHS, there was no association between OSA and melanoma risk (RR 1.04 (95% CI, 0.42-2.55)) and there was also no association between snoring status and melanoma risk in the three cohorts.
In this prospective study, we found that OSA was associated with an approximately two-fold increased risk of psoriasis among US women and we found no association between sleep duration, sleep apnea, or snoring and melanoma risk among US women and men.
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Spörndly-Nees, Søren. "Physical activity and eating behaviour in sleep disorders." Doctoral thesis, Uppsala universitet, Sjukgymnastik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-308395.
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Sleep-disordered breathing and insomnia are common sleep disorders and associated with an increased risk of morbidity. The aim of this thesis was to study the contribution of a behavioural sleep medicine perspective on sleep-disordered breathing and insomnia. More specific, factors considered important for changing eating behaviour and the impact of physical activity were studied. Methods: In study I, semi-structured interviews of participants with obstructive sleep apnoea and obesity (n = 15) were analysed using a qualitative content analysis. A population-based female cohort was followed prospectively over ten years in study II and III using a postal questionnaire on two occasions (n = 4,851 and n = 5062, respectively). In study IV, a series of five experimental single-case studies was conducted testing how an aerobic exercise intervention affected selected typical snores, following an A1B1A2B2A3 design over nine days and nights (n = 5). Results: Facilitators and barriers towards eating behaviour change were identified. A low level of self-reported leisure-time physical activity was a risk factor among women for future habitual snoring complaints, independent of weight, weight gain alcohol dependence or smoking. Maintaining higher levels or increasing levels of leisure-time physical activity over the ten-year period partly protected from snoring complaints (study II). Further, a low level of self-reported leisure-time physical activity is a risk factor for future insomnia among women. Maintaining higher levels or increasing levels of leisure-time physical activity over the ten-year period partly protect against self-reported insomnia, independent of psychological distress, age, change in body mass index, smoking, alcohol dependence, snoring status or level of education (study III). Single bouts of aerobic exercise did not produce an acute effect on snoring the following nights in the studied individuals. A pronounced night-to-night variation in snoring was identified (study IV). Conclusion: Women with sleep disorders would benefit from a behavioural sleep medicine perspective targeting their physical activity in the prevention and management of snoring and insomnia. This is motivated by the protective effects of physical activity confirmed by this thesis. Knowledge was added about facilitators and barriers for future eating behaviour change interventions.
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Virkkula, Paula. "Diagnosis of sleep-related breathing disorders esophageal pressure monitoring, nasal resistance and postural cephalometry." Helsinki : University of Helsinki, 2003. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/virkkula/.
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Takegami, Misa. "Simple four-variable screening tool for identification of patients with sleep-disordered breathing." 京都大学 (Kyoto University), 2009. http://hdl.handle.net/2433/126592.
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Kyoto University (京都大学)0048
新制・課程博士
博士(社会健康医学)
甲第15000号
社医博第27号
新制||社医||6(附属図書館)
27450
UT51-2009-R724
京都大学大学院医学研究科社会健康医学系専攻
(主査)教授 今中 雄一, 教授 川上 浩司, 教授 三嶋 理晃
学位規則第4条第1項該当
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Felix, Moscoso Monica, Galvan Jack Denegri, Loayza Fernando Ortega, and Adrian V. Hernandez. "Respiratory Therapy in Chronic Heart Failure Patients Complicated With Sleep-Disordered Breathing: Potential Study Bias." Journal of the Japanese Circulation Society, 2016. http://hdl.handle.net/10757/611825.
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MacLeod, Kendra Deanne. "Evaluating Adherence to Continuous Positive Airway Pressure Therapy in Children with Sleep-Disordered Breathing." University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1235768185.
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Lei, Ka-weng, and 李加穎. "Relationship between tonsil/adenoid size and the frequency of respiratory event in sleep-related breathing disorders in children." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44660182.
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Mulvaney, Shelagh. "Behavioral and cognitive correlates of sleep-disordered breathing in a community sample of school children." Diss., The University of Arizona, 2002. http://hdl.handle.net/10150/280100.
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Sleep disordered breathing has been related to problems with memory, attention, executive function and mood disturbance in adults. Similar cognitive as well as behavioral deficits have been hypothesized as daytime consequences of SDB in children. The cognitive and behavioral manifestation of SDB in children may appear similar to ADHD with decrements in attention and increased behavioral impulsivity and hyperactivity. SDB is ideally measured using some combination of reduced airflow, hypoxemia, and sleep fragmentation from overnight polysomnography, although some researchers have used parent report to create research samples. Currently, few pediatric studies exist that examine behavior and cognition in the presence of overnight polysomnographic data. The present study was derived from the Tucson Children's Assessment of Sleep Apnea (TuCASA) which was broadly designed to determine the prevalence of SDB and it's correlates in normal school children ages 6-12. The present analyses were designed to relate SDB as a whole as well as its components to sustained attention and behavior in that population. In addition, the relationship between sleepiness and hyperactivity was examined, as these are two seemingly incongruent manifestations of SDB. Measures of attention and behavior included the Test of Everyday Attention for Children (TEACh), the PVT-192, and the Conners' Parent Rating Scales-Revised. Results indicated that for children with elevated respiratory disturbance indexes (RDI), problems of attention and behavior did not reach clinically relevant levels. However, children were much more likely to show significantly higher levels of a variety of behavioral problems given an elevated RDI. In general linear models, the interaction of two components of SDB predicted performance on two measures of sustained attention, and predicted parent rated levels of Psychosomatic Complaints and Perfectionism. Sleepiness and hyperactivity were not related to each other. Behavioral manifestations of SDB tended to vary with age. Older children showed increased behavior problems at the highest levels of SDB while younger children showed decreased behavior problems. Overall, these results indicate that even in healthy children variation in sleep related breathing may be related to daytime cognition function and behavioral regulation.
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SUKEGAWA, MAYO, AKIKO NODA, TARO SOGA, YUKI ADACHI, YOSHINARI TSURUTA, NORIO OZAKI, YASUO KOIKE, and 真代 助川. "COMPARISON OF SLEEP-DISORDERED BREATHING AND HEART RATE VARIABILITY BETWEEN HEMODIALYSIS AND NON-HEMODIALYSIS DAYS IN HEMODIALYSIS PATIENTS." Nagoya University School of Medicine, 2008. http://hdl.handle.net/2237/10544.
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Goodwin, III James Lester. "The natural history of sleep disordered breathing in 6-11 year old Caucasian and Hispanic children." Diss., The University of Arizona, 2002. http://hdl.handle.net/10150/280181.
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Sleep disordered-breathing (SDB) including obstructive sleep apnea syndrome (OSAS) is increasingly recognized as an important cause of morbidity in children. Clinical symptoms of OSAS in children include snoring, nocturnal arousals, restlessness during sleep, enuresis, daytime sleepiness and hyperactivity. Evidence also suggests that the adverse effects of SDB include behavioral, learning, and personality problems. No large epidemiological study using polysomnography has been conducted to determine the prevalence and correlates of SDB in young children. The Tucson Children's Assessment of Sleep Apnea study (TuCASA) is a prospective cohort study designed to determine the prevalence of objectively documented SDB in pre-adolescent children and to investigate its relationship to symptoms, performance on neurobehavioral measures, and physiologic and anatomic risk factors. Hispanic and Caucasian children were recruited to participate in TuCASA by soliciting the cooperation of elementary schools in the Tucson Unified School District (TUSD). Through the use of a screening survey completed by parents, the TuCASA study has shown that children between 4-11 years of age with learning problems (LP) are more likely to have habitual snoring (SN) and excessive daytime sleepiness (EDS). Additionally, Hispanic children in this age group are more likely to have parental report of EDS, witnessed apnea (WA), and SN. Similar to studies in adults, girls 4-11 years of age are more likely to have parental report of daytime sleepiness than boys. Furthermore, the TuCASA study has demonstrated the feasibility of collecting high quality unattended multi-channel polysomnography in children ages 5 to 12 years. More importantly, the TuCASA study has documented the relationships between respiratory disturbance indices based on polysomnography and parental report of clinical symptoms of SDB in children ages 6-11. There are threshold values of respiratory disturbance index (RDI) associated with an increase in the prevalence of clinical symptoms of SDB. Until now, data linking objective indices of RDI severity to the presence of clinical symptoms have been lacking. Additionally, these findings contribute much needed information for determining clinically significant levels of RDI based on differing definitions of respiratory events. Therefore, these results represent an important step towards examining the natural history of SDB and the relationship between SDB severity and specific clinical outcomes in pre-adolescent children.
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Mietchen, Jonathan James. "Parent-Reported Deficits in Executive Function and Sleep-Disordered Breathing in Adolescent Behavioral Weight Loss Program Participants." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6386.
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Children and adolescents with obesity and overweight are at increased risk for developing sleep disordered breathing (SDB) and SDB has been associated with cognitive deficits and executive dysfunction. The aim of this study was to examine the relationship between executive functioning and SDB among adolescents participating in a behavioral weight loss intervention. Adolescents (n = 37) and their caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF) and caregivers completed the Pediatric Sleep Questionnaire (PSQ). Using the Sleep Related Breathing Disorder scale on the PSQ adolescents were classified as at risk or not at risk for SDB. Correlations were calculated to evaluate associations between executive function and SDB. MANOVA analyses were also conducted to determine whether significant differences in executive function exist between adolescents at risk for SDB, and those not at risk. Significant correlations were found between SDB and executive functioning (r = 0.75; < .001). Significant differences were observed between SDB risk and non-SDB risk groups on the BRIEF parent report (F (1, 35) = 3.73; < 0.01). Differences in parent-report BRIEF scores across risk groups represent a large effect (d = 1.73). However, these differences were not replicated on the BRIEF self-report (F (1, 35) = 1.24; p < 0.05). Adolescents with overweight or obesity participating in behavioral weight loss interventions may be at increased risk for SDB and those adolescents at risk for SDB may have executive dysfunction. These deficits may have implications for treatment.
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Badgley, Jennifer Ayala Chute Douglas L. "Sleep-disordered breathing in children and adolescents with Systemic Lupus Erythematosus and its association with executive functioning /." Philadelphia, Pa. : Drexel University, 2008. http://hdl.handle.net/1860/2802.
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Muscat, Vanessa. "Improving the diagnosis of obstructive sleep disordered breathing in infants by incorporating esophageal manometry into conventional polysomnography." Title page and summary only, 1999. http://web4.library.adelaide.edu.au/theses/09SB/09sbm985.pdf.
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Thesis (B. Sc.(Hons.))--University of Adelaide, Dept. of Physiology, 2000?Spine title: Diagnosing obstructive sleep disordered breathing in infants. Includes bibliographical references (leaves 32-35).
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Ngiam, Joachim. "Objective measurement of sleep disordered breathing in mandibular advancement splint and rapid maxillary expansion therapy with the Sonomat™." Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/24011.
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In both adults and children, anatomic factors have increasingly been implicated as a key contributory factor to upper airway obstruction and obstructive sleep apnea (OSA). Craniofacial and dento-morphological abnormalities such as maxillary constriction or mandibular retrusion have also been highly associated with adults and children who snore or have OSA. Dental treatment of these common craniofacial abnormalities often involves the use of rapid maxillary expansion (RME) and mandibular advancement splint (MAS) therapies. This thesis investigates the effects of RME in children and MAS treatment in adults using a novel diagnostic test, the Sonomat™ which has been developed at The University of Sydney for the diagnosis of sleep disordered breathing. The Sonomat™ has been validated against polysomnography. It is able to generate sleep-related indices such as the apnea hypopnea index and also provides an objective measurement of snoring. Overall, both RME and MAS therapies were beneficial for a good majority of adults and children with a subset of patients receiving little benefit from the respective therapies. Further studies are required to identify subjects who do not benefit from RME or MAS therapy and alternative treatment options or combination therapies may be warranted in these patients.
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Harada, Yuka. "Differences in Associations between Visceral Fat Accumulation and Obstructive Sleep Apnea by Sex." Kyoto University, 2014. http://hdl.handle.net/2433/189343.
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